Dont forget NDC # for J3490
Dont think anyone has mentioned an important part of J3490 rules (apologize if I overlooked & am repeating)
Injections have numerous rules per carrier so always be sure to check each carriers rules prior to billing but I am writing the basics from my exp. with billing J3490 and other J and S injection codes.
J3490 is a "junk" code meaning it doesnt have a specific NDC#
(which the NDC# is located on the packaging the bottle comes in
Since these days most meds for injections have a specific HCPCS code, be sure to verify prior to billing that code:
1. that there isnt a specific J code you should be using instead of J3490
2. if you locate a HCPCS J code, then also verify total cc/ml/mg per unit , so you dont overbill (ex. code shows 20 mg/cc or ml in description, documentation show 40cc given, then you would bill 2 units)
3. Look up the J or S code (online if you dont have a new HCPCS book) and verify the NDC#'s you have match the NDC# for that code because some J codes have more than 1 to select from dep. on concentration of medicine.
4. J and S codes change so verify the code is still valid & ensure if you locate a J or S code via searching the internet that the code is still valid via a new HCPCS book.
(20mg, 40mg & 60mg are ex. of the diff. in regards to the same name of 1 med. but if 20cc/mg/ml it may show as J1020, then a 40mg would show as J1030 and a 40mg. would have a HCPCS J code of J1040 & each of those J codes have different NDC's as a way to defientely know you have the right HCPC's code to bill)
Billing TIP:
If sending paper claims, (or if you use Medisoft) you can either:
Add the NDC# to the Local Use B field (Box 19 on the CMS form)
I use Medisoft, so I enter it either the NDC# in the patient's case on the Miscellanous tab. (local Use B field).
Most carriers will allow you to write the NDC number in Local Use B field or right above the J3490 line. So check your carriers rules to ensure accuracy.
if no J or S code is specific to medication you are giving then yes use the J3490 code:
If J3490 is the code then be sure to write total #of cc/mg or ml given to the patient per documentation as the units (J3490 is per 1cc/mg or ml per unit).
Would love other billers/coders to give their experiences with injections and any tips they have to coding/billing J or S codes correctly the first time!